This invention relates to medical diagnostic apparatus, and more particularly to a computer based system for pulmonary diagnosis based on measured performance of the lungs during selected testing.
The use of computer based systems in forming medical diagnoses, and more particularly in diagnosing pulmonary function, is well known. Evaluation of pulmonary condition involves measurement of the size of the lungs, the limitation to air flow, e.g. flow rates, the adequacy of gas exchange (diffusion), and response to aerosol drugs (bronchodilator response). Such pulmonary function testing typically generates up to sixty parameters for evaluation. Manual examination of the results of such testing is tedious and time consuming. A computer program for calculating and interpreting standard pulmonary function test data is disclosed by Ellis, Pareja and Levin in 1975 (Chest Volume 68: Pages 209-213, 1975). This and like systems were directed principally to identifying abnormal parameters. While diagnosis can be simplified by focusing on key parameters, this increases the risk of overlooking subtle anomalies.
As disclosed by Fallat and Snow (Comp. Med. Volume II, No. 3: Pages 14-18, 1984), a program designated "Micropuff" has been developed in an effort to mirror a clinician's approach to analyzing pulmonary function data, utilizing a personal computer. The Micropuff program aids interpretation by first identifying various parameters among those tested as abnormal, and then applying abnormality flags to a set of rules for generating conversational text, tailored to the individual physician. Diagnostic statements generated as a result of this analysis are subject to final correction by or for the physician, for example through conventional word processing techniques. Fallat and Snow reported the results of testing, in which seventy-five percent of the computer generated interpretations were accepted without modification. Further, substantial time is saved because the physician edits, rather than creates, the diagnostic text.
While the Micropuff program has been successful in certain respects, it also has shed light on the need to tailor pulmonary diagnostic systems to the interpretation habits and syntax of individual physicians. Moreover, the same physician may wish to interpret pulmonary function test parameters based on different approaches tailored to special situations, for example epidemiology studies.
Therefore, it is an object of the present invention to provide a pulmonary function analysis system which can be modified by the physician in accordance with his or her analytical approach.
Another object of the invention is to provide pulmonary function diagnostic apparatus for identifying selected pulmonary function parameters as abnormal, and further for identifying the degree or extent of abnormality, in accordance with values predetermined by the physician.
Yet another object is to provide a pulmonary analysis system for generating preliminary diagnoses of pulmonary function, including textual statements, wherein the bases for selecting among the textual statements, and content of the statements themselves, are subject to physician modification.